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BMJ Case Reports 2017; doi:10.1136/bcr-2016-217943
  • CASE REPORT

Vascular challenges from pancreatoduodenectomy in the setting of coeliac artery stenosis

  1. Roderich E Schwarz
  1. Department of Surgery Division of Surgical Oncology, Indiana University School of Medicine, South Bend, Goshen, Indiana, USA
  1. Correspondence to Dr Roderich E Schwarz, rschwarz{at}goshenhealth.com
  • Accepted 3 March 2017
  • Published 16 March 2017

Summary

Coeliac artery stenosis due to median arcuate ligament compression or atherosclerotic disease is a frequently unrecognised challenge to recovery after pancreatoduodenectomy. The described case illustrates management with intraoperative superior mesenteric artery to hepatic artery bypass graft that led to haemorrhagic challenges postoperatively but ultimately a good recovery. Aspects of preoperative diagnosis, preoperative intervention and intraoperative management options are reviewed. Surgeons need to possess these tools to prevent complications from coeliac artery stenosis when pancreatoduodenectomy is required.

Footnotes

  • Competing interests None declared.

  • Patient consent Not obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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